Cancer is a serious disease that necessitates treatment. Patients seek cure by obtaining standard medical treatment (SMT), also known as Western medicine or biomedicine. SMT has been developed over a long period; it relies on evidence-based research methods and has a scientifically proven benefit in treating cancer [1]. SMT for patients with cancer includes systemic treatment, radiotherapy, and surgery. Owing to the seriousness of this disease, patients tend to seek every potential treatment, including those other than SMT [1]. Patients with cancer use complementary and alternative medicine (CAM) for many reasons, including curing the disease, reducing the adverse effects of SMT, and boosting patient’s immunity [1], [2], [3]. CAM is categorized into alternative and complementary therapies [3], [4].

Dietary intake and the use of complementary therapies, particularly natural compounds, have long been recognized for their significant role in maintaining human health and preventing chronic diseases [5]. Numerous epidemiological and experimental studies have shown that bioactive components derived from foods can interfere with several cell signaling pathways. In recent years, growing attention has been directed toward the potential of these natural compounds not only in prevention but also in the management of cancer, through mechanisms such as inhibition of tumor growth, angiogenesis, some of these copmounds are curcumin (turmeric), resveratrol (red grapes, peanuts and berries), genistein (soybean), S-allyl cysteine (allium), allicin (garlic), lycopene (tomato), capsaicin (red chilli), diosgenin (fenugreek), 6-gingerol (ginger), ellagic acid (pomegranate), ursolic acid (apple, pears, prunes), silymarin (milk thistle) [6]. As a result, CAM—including dietary interventions and herbal medicines—are increasingly being integrated into conventional cancer care strategies, particularly when supported by robust scientific evidence and clinical guidance. Yet no CAM approach has been shown to cure cancer [7]. Moreover efficacy and safety of many of the traditionally used CAM cannot be guaranteed, as most of these remedies and practices have not been thoroughly validated scientifically [8], [9]. Some CAM types might not be sufficiently pure for use by immunocompromised patients. Moreover, certain CAM types are harmful by nature, and others might inherently contain toxic materials and chemicals [10], [11]. Furthermore, even CAM products lacking any of the abovementioned concerns could interact with SMT in a synergistic or inhibitory manner [4], [7], [12]. In addition, the doses and administration frequencies of CAM products are not well-defined, and their use is not regulated or monitored by regularity entities [4].

The use of CAM is influenced by several factors, such as culture, level of education, socioeconomic status, and health literacy [1], [13], [14], [15], [16]. Evidence has shown a considerable increase in CAM use in recent years [17]. Many studies have reported the rates of CAM use among adults with cancer in various countries, with a prevalence rate of 35 %–82 % [4], [18], [19], [20]. Among adult patients with cancer in Saudi Arabia, the prevalence of CAM use is estimated to be 52.9 %–96.8 % [21], [22], [23].

A systematic review reported that the prevalence of CAM use among pediatric patients with cancer ranged from 6 % to 100 % [1]. The only country with a 100 % rate of CAM use was Saudi Arabia; however, this finding was based on the results of a small pilot study (n = 40) [2]. In the Gulf region and Arab world, there has been limited research on the use of CAM among pediatric patients with cancer [3]. Obtaining a precise estimate of CAM use rates among pediatric patients with cancer is crucial for healthcare providers and health policymakers.

This study aimed to assess the prevalence of CAM use among pediatric patients with cancer in Saudi Arabia. This study also explored the perspectives and opinions of the caregivers of these patients regarding CAM use.